Tristram Shandy and Contemporary Discussion of Midwifery

The first four volumes of Laurence Sterne’s The Life and Opinions of Tristram Shandy, Gentleman center on the conception and birth of the eponymous character—if they can truly be said to “center” on anything at all. The novel opens at the moment of Tristram’s conception and continues on to detail the origins of the town midwife, the terms for childbirth set out in his parents’ marriage settlement, his father’s obsessions with baby naming and caesarian sections, the strained relationship between midwife and local doctor, and the outcome of an unfortunate nose-flattening accident resulting from the use of forceps to finally deliver the infant Tristram. Yet in spite of all this, Mrs. Shandy plays a comically negligible role in Tristram’s narrative. Her dialogue—especially compared to Walter’s—is infrequent and brief, and even as she is in labor with Tristram, readers’ attention is drawn not to the mother and child, but to their male relatives conversing in the parlor below them. The infrequent glimpses we do get at the process of childbirth are delivered second-hand by the servant Susannah to Mr. Shandy, Uncle Toby, and Dr. Slop, whose absurd absence from and inattention towards the birth perhaps echoes that of the reader.

Given the general absence of women from a text so thoroughly concerned with the conception and birth of an infant, it may initially seem reasonable to suppose that the writing of Tristram Shandy was contemporaneous with a shift from traditional, female-dominated midwifery to a new, male-dominated obstetrics. With advancements in medicine placing male doctors at the center of such a traditionally feminine activity, it could stand to reason that Sterne might choose to satirize this change. By obviously obscuring Mrs. Shandy’s participation in the birth of her own child and focusing instead on the pedantic ramblings of Mr. Shandy, who for all his education does not seem to have the slightest idea why the notion of an unanaesthetized caesarian section might alarm an expectant mother, the novel exposes the absurdity of overambitious and/or unnecessary male interference in childbirth, often at the expense of the mother’s agency and authority over the process.

A brief exploration of midwifery texts available from Eighteenth Century Collections Online seems to uphold this interpretation. Ordered chronologically, the list of forty-nine works available on the subject of “midwifery” begins with texts written primarily by and for women. These texts, authored mostly by midwives, seem to have been directed at helping women exercise a degree of agency in their pregnancies. Their titles include phrases like “the womans councellor” and “Directing child-bearing women how to order themselves in their conception, breeding, bearing, and nursing of children.” This second book, whose shortened title may be rendered as The Midwife’s Companion by Mrs. Jane Sharp, apparently sold very well, going through four editions by 1725. However, in keeping with the hypothesis that childbirth was beginning to fall under the purview of male medical professionals when the first volumes of Tristram Shandy were released in 1759, the woman-centric texts on ECCO’s list give way to predominantly male-authored works by the 1730s. This change is accompanied by what seems to be the sparking of several contentious debates, including arguments for and against the use of medical instruments such as forceps and one set of letters by a former male midwife protesting “The danger and immodesty of the present too general custom of unnecessarily employing men-midwives.” In light of such change and debate in the field of midwifery, the focus of the first half of Tristram Shandy on conception and birth seems very timely, and the likelihood that Sterne is aware and in some way responding to these debates seems very high.

A closer look at one text in particular helps to contextualize much of the novel within contemporary conversation about human reproduction. Although it does not appear in a subject search for “midwifery” on ECCO, John Maubray’s handbook on midwifery, whose elephantine title is best reduced to The Female Physician, seems to have been fairly popular in its time, and to have made a lasting impact on the field of midwifery and obstetrics. Although it went through just two editions, or half the printings of the competing Midwife’s Companion, it is perhaps testimony to the enduring legacy of the erasure of women’s authority on the subject during this period that Herbert R. Spencer, in his History of British Midwifery refers to Maubray—rather than Sharp or another woman midwife—as “the first teacher of practical midwifery” (14). Apparently, Maubray agreed: “What books of midwifery have we ever had in England but bare translations?” (11). For the author of a book called The Female Physician, Maubray seems to have had a talent for disregarding contemporary midwives, the truly expert among whom could perhaps even be dubbed “female physicians.”

Perhaps the most likely reason that Maubray and subsequent historians ignored earlier female author-midwives in their claims that The Female Physician was the first book of its kind and Maubray the first teacher of his kind, is that The Female Physician draws extensively on classical sources rather than pure experience. Just as Tristram’s father justifies his own opinions and arguments with reference to Copernicus, Slawkenbergius, Bishop Ernulphus , and a great number of other authorities both real and fictional, Maubray writes his midwifery manual as a commonplacing exercise—and a somewhat digressive, almost Shandean one, no less. In addition to liberally peppering his chapters on copulation with untranslated Latin quotes and references to Lactantius (53-57) and citing Hippocrates and a number of other ancients to claim that no woman outside of the Greek island of Naxos may safely give birth to a healthy child in the eighth month of gestation (140-2), he even cites St. Augustine’s claim that by sheer willpower, some men are able to relocate their ears to a different part of the head or sweat voluntarily, in an only loosely related chapter on imagination (58). At times, it even seems as if in the digressive style of Tristram Shandy, Sterne could just as easily have been imitating—and criticizing—Maubray’s Female Physician as Burton’s Anatomy of Melancholy.

Beyond mere similarities in style, Maubray’s book addresses many of the issues Sterne seems to satirize in Tristram Shandy, from the notion that parents’ thoughts during conception can affect the mind and body of a developing infant (59-63) to the new enthusiasm for tools and techniques such as forceps and the dreaded caesarian section. Interestingly, as much as Maubray seems to appropriate women’s former authority on the subject of midwifery through his extensive employment of scholarly reference, he also takes a stand against the advancement of technology into the birthing process. His motives are perhaps made clear in his words on the subject of forceps:

what can be more inconsistent with the tender NATURE of Women, or more terrible to them, than to see Men come armed against Themselves and their tender INFANTS, with Knives, Hooks, Lon[g?] Forceps, &c…? I am Positive, that let who will use INSTRUMENTS, they kill many more INFANTS than they save and ruin many more WOMEN than they deliver fairly. (181)

If Dr. Slop’s forceps are anything like the real tools used in the eighteenth century, then Maubray is probably right. However, his attitude here is paternalistic, invoking “the tender NATURE of Women… and their tender INFANTS” to gain his audience’s sympathy, as if it is women’s fear and softness rather than the crudeness of the tools themselves which renders their use dangerous. While Maubray seems to favor the progress of male scholarly expertise into the arena of reproduction, disregarding his female predecessors and in fact suggesting that a gentle, modest, educated male midwife is more ideal than a standard female midwife (178-81), he opposes the introduction of too much technology on the grounds that naturally delicate women and children cannot withstand its use. Maubray’s suggested motive then, for appropriating authority from women is to protect them. With his scholarly text on women’s ailments and childbirth, Maubray does not quite remove all agency from women, nor does he endorse greatly invasive procedures to be practiced on them; instead, he offers himself—and the ancient scholars he cites—as male authorities for women to follow. As he states in his introduction, “I have endeavor’d to be most particular… to the end that any Woman… may know before She sends for her Physician, not only her Distemper, but also the Danger” (xiv). Having informed women how to interpret their symptoms, Maubray directs them to a male authority for assistance. While not as thoroughly erased from the process of birth as Mrs. Shandy, Maubray’s female readers are subordinated to higher male authorities.

In conclusion, it seems that the absence of Tristram’s mother from a much of the narrative of his birth reflects a contemporary removal of women from the scholarly conversation on childbirth and their relegation to more subordinate roles in the process. The conversation between Walter, Toby, and Dr. Slop in the parlor as Elizabeth Shandy gives birth on the next floor resembles the greater attention starting to be paid to male “experts” on childbirth who could in no way have the same intimate connection to the physical act of giving birth as the women undergoing it; this resemblance may be intended as satire. Male scholars with little or no practical experience as midwives adopted an attitude similar to Walter Shandy’s air of expertise based on citation of ancient—often eccentric or inaccurate—sources.

Works Cited

Maubray, John. The Female Physician, Containing all the Diseases incident to that Sex, in Virgins, Wives, and Widows; Together with their Causes and Symptoms, their Degrees of Danger, and respective Methods of Prevention and Cure: To which is added, The Whole ART of New improv’d Midwifery; Comprehending The necessary Qualifications of a Midwife, and particular Directions for laying Women, in all Cases of Difficult and Preternatural Births; together with the Diet and Regimen of both the Mother and Child. London: James Holland, 1724. Print.

Sharp, Jane. The Compleat Midwife’s Companion: Or, the Art of Midwifry Improv’d. Directing Childbearing Women how to Order themselves in their Conception, Breeding, Bearing, and Nursing of Children. London: John Marshall, 1724. Early Eighteenth Century Collections Online. Early Eighteenth Century Collections Online. Web. 10 Apr. 2012. <http://find.galegroup.com.proxy.lib.uiowa.edu/ecco/retrieve.do?sgHitCountType=None&sort=DateAscend&tabID=T001&prodId=ECCO&resultListType=RESULT_LIST&searchId=R6&searchType=AdvancedSearchForm¤tPosition=3&qrySerId=Locale%28en%2C%2C%29%3AFQE%3D%28SU%2CNone%2C9%29midwifery%3AAnd%3ALQE%3D%28BA%2CNone%2C60%290LRH+Or+0LRL+Or+0LRI+Or+0LRK+Or+0LRF+Or+0LRJ+Or+0LRN+Or+0LRM%24&retrieveFormat=MULTIPAGE_DOCUMENT&userGroupName=uiowa_main&inPS=true&contentSet=ECCOArticles&&docId=CW3307173931&retrieveFormat=MULTIPAGE_DOCUMENT&docLevel=FASCIMILE&workId=CW3307173931&relevancePageBatch=CW107173930&showLOI=Yes&contentSet=&callistoContentSet=ECLL&docPage=article&hilite=y>.

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